Adjusted calcium conflict resolved? Differing effects on plasma total calcium of changes in plasma albumin after venous stasis or myocardial infarction.

Others have challenged the concept of adjusting total plasma calcium for albumin concentration on the grounds that after the application of a tourniquet the increase in calcium for a given increase in albumin differs significantly between normal individuals. We have confirmed this finding. In contrast, we have found that after myocardial infarction the fall in calcium for a given fall in albumin does not differ significantly between patients. Thus the adjustment of calcium for albumin using a single equation remains valid in patients with changes in albumin due to disease. We recommend that for consistent results blood should be taken with the minimum of venous stasis even though the patient's calcium is to be adjusted for albumin.